Adjunctive Subgingival Administration of Andrographis paniculata Gel in the Treatment of Chronic Periodontitis: Microbiological and 3-hydroxy Isobranched C_17:0 Study in Hopeless Teeth

Objectives: Bacterial lipid containing 3-OH iC_17:0 from plaque and calculus-root surface had shown to penetrate the adjacent gingival tissue and stimulate prostaglandin secretion from gingival fibroblast and monocytes. The aim of this study is to determine the effect of adjunctive administration of Andrographis paniculata gel on 3-OH iC_17:0 on the root surface and in subgingival plaque and its antimicrobial effect on gram-negative pigmented anaerobes. Methods: Thirty chronic periodontitis patients with at least 2 periodontally hopeless single-rooted teeth were randomly divided into Andrographis paniculata gel groups and no gel groups. At day 0, one tooth in each group was treated by scaling and root planing and the other was treated by supragingival plaque removal. In the gel groups, gels were applied to both teeth on day 0 and 7. Microbiological sample was collected on day 0 and 7. The plaque lipid sample was collected on day 0, 7 and 8. Calculus-root lipid sample was obtained on day 8 after tooth extraction. Results: Adjunctive administration of the gel decreased both the amount of calculus-root lipid and of plaque lipid significantly. Scaling and root planing alone showed similar pattern of reduction. However, gel alone reduced calculus-root lipid significantly but not the plaque lipid. The microbiological study demonstrated no significant decrease in number of pigmented anaerobes in all groups. Conclusions: Adjunctive treatment of Andrographis paniculata gel was effective in reducing bacterial lipid containing 3-OH iC_17:0 on root surface and in subgingival plaque. The gel alone was effective in reducing it on root surface. Neither adjunctive use of the gel nor gel alone were effective on number of gram-negative pigmented anaerobes. Supported by Ministry of University Affair. Grant 2001-2002.